What happens to your Brain in a Traumatic Brain Injury

Posted by Stevenson Whelton LLP
September 19, 2019


Traumatic brain injury can be caused by a blunt impact, penetrating injury or blast injury. And, traumatic brain injuries range from mild to severe, although the vast majority of brain injuries are mild.

Immediate Damage that occurs in Traumatic Brain Injury

A brain injury can be associated with a closed head injury, or an open head injury or penetrating injury. The type of head injury generally effects how localized is the damage to the brain and which areas of brain function are impacted.  And, depending on the type and severity of injury, a brain injured person may sustain bruising to brain tissue and tissue damage, damage to nerves and axons, and torn blood vessels. 

Open head or penetrating injuries often result in more localized damage, although this is not necessarily the case.  A closed head injury is typically caused by the head being violently moved back and forth and colliding with the skull, and can result in serious damage throughout the brain (diffuse axonal injury).

A skull fracture involves breaking or denting in the skull.  When this occurs, parts of the skull or pieces of bone can press on the brain and cause damage.

Localized injury to the brain, such as due to a penetrating injury, can result in contusions (bruising) and/or hemorrhaging (bleeding) near the surface or in any layers of the brain.

Epidural hematoma occurs in less than four percent of serious head injuries and it is characterized by bleeding between the skull and outer membrane covering the brain. 

Diffuse axonal injury involves widespread damage to the brain and involves tearing or stretching injuries to the neurons and axons in the brain. Neurons are the cell bodies of the brain and axons are fibers that facilitate communication between neurons.  If a brain injury causes too much damage to the axon, such as tearing, pulling and stretching, the neuron will perish. When a person sustains diffuse axonal injury, then neurons throughout the brain are damaged and this can substantially interfere with bodily functions.  

About 50 percent of persons of sustain a severe head injury require surgery to repair or remove ruptured blood vessels (hematomas) and/or bruised tissue.

Secondary Injuries that may occur in Traumatic Brain Injury

Aside from preventing a brain injury from occurring in the first place, which is the objective of protective gear such as bicycle helmets and airbags, there is nothing that can be done to prevent initial or primary damage caused by a traumatic brain injury.  However, secondary injuries can often be prevented or mitigated if the injured person seeks prompt medical treatment.  This fact has instigated changes in concussion protocol for athletes and amateur sports, as well as guidelines for the Ontario’s Physical Education program.   

Secondary injuries usually occur in the hours or days after a traumatic brain injury and are caused by a lack of oxygen to the brain or to parts of the brain, or result from increased pressure inside the skull (intracranial pressure).  Intracranial pressure can result when contusions and bleeding in the brain causes the brain tissue to swell.

In March 2009, actress Natasha Richardson tragically died after sustaining a blunt impact to her head during a skiing accident at a Mount Tremblant resort in Quebec. The resort’s ski patrol believed the accident was serious enough to call an ambulance, but the call was cancelled after the actress chose not to wait for the ambulance and walked back to her nearby hotel.  She also believed her injuries weren’t serious enough to  to seek treatment from the medical clinic adjacent to the hotel.  However, after about two hours, Ms. Richardson began to experience severe headaches and as a result, the hotel called 911.  Tragically, by the time the actress reached the nearest Montreal trauma center, epidural hematoma in her brain had caused catastrophic brain damage - a blood clot had formed in her brain and caused pressure against her skull.  She was subsequently transferred to a New York State hospital, but was beyond help and was placed on life-support.

Regardless of the severity of a brain injury, inflammation plays an integral role in the disrupted physiological processes associated with traumatic brain injury.  Brain trauma causes the brain to release active inflammatory substances, such as cytokines, which cause second-level damage to the brain.  And, the more significant the brain injury, the greater and more prolonged the inflammatory response.  The more time that has passed after a traumatic brain injury, a stroke event or the onset of Alzheimer’s disease, the more these conditions begin to resemble one another.  This is because chronic inflammation in the brain is characteristic of all three conditions.

Disabilities resulting from Traumatic Brain Injury

The parts of the body and body functions that are impacted by a traumatic brain injury depend on the part of the brain that was injured, the severity of injury, and the general health and age of the victim.  In many cases, disabilities associated with a brain injury have serious and long-term effects on the person’s ability to function in normal activities, at work and in social interactions.  Below are common disabilities that can result from a traumatic brain injury. 

  • Cognition problems: difficulty with memory, thinking and decision making
  • Mental health conditions: depression, anxiety and post-traumatic stress disorder
  • Behaviour issues and personality changes: inappropriate behaviour, aggression, acting out, isolation
  • Sensory processing problems affecting any or all senses
  • Communication difficulties: difficulty with understanding and speech

In the case of very serious head injuries, an accident victim may be in an unresponsive state (from which they can be aroused briefly) or coma (where the person is totally unresponsive and unaware).

If you or a loved one sustained a traumatic brain injury in an accident caused by another person’s negligence and would like to make a claim for damages, talk to a knowledgeable brain injury lawyer. At Stevenson Whelton MacDonald & Swan, we well-understand the disabling effects suffered by brain injury victims and the effect on their families and caregivers.   Let us help you get the compensation you are owed and deserve.    

Disclaimer: Our blog is intended to inform our existing and prospective clients about topics pertinent to their lives. While our goal is to provide accurate and factual information, this in no way should be taken as legal advice or applied to specific cases. It is in your best interest to contact a licenced and practising lawyer for legal representation, as matters of the law are often complicated and cannot be fully assessed without knowing all of the details of a case.